盘点:2019年5月25日Lancet研究精选

2019-05-25 MedSci MedSci原创

2019年5月25日Lancet研究精选

【1】左乙拉西坦对小儿惊厥性癫痫的二线治疗效果不优于苯妥英


苯妥英钠是目前儿科惊厥性癫痫患者在一线苯二氮卓失效后的二线治疗的标准治疗方法,但仅对60%的病例有效,左乙拉西坦是一种安全有效的癫痫治疗药物,近日研究人员比较了苯妥英和左乙拉西坦二线治疗儿童惊厥性癫痫的疗效。

3个月至16岁,一线苯二氮卓治疗失败的惊厥性癫痫儿童参与研究,随机接受20 mg/kg苯妥英或40 mg/kg左乙拉西坦,主要结果是药物输注结束后5分钟临床上停止癫痫活动。233名儿童患者参与研究,114名接受苯妥英,119名接受左乙拉西坦。苯妥英钠组68例(60%)患者和左乙拉西坦组60例(50%)患者在完成研究药物输注后5分钟临床上停止了癫痫发作(风险差异-9.2%)。

研究认为。

【2】左乙拉西可缩短二线小儿惊厥性癫痫患者症状停止时间


在英国,苯妥英是二线治疗小儿惊厥性癫痫的推荐药物,然而,一些证据表明左乙拉西坦可能是一种有效和安全的替代选择。近日研究人员比较了苯妥英与左乙拉西坦对小儿惊厥性癫痫二线治疗的疗效和安全性。

6个月至18岁以下的,需要二线治疗的癫痫患儿参与研究,随机接受左乙拉西坦(40 mg/kg,5 min)或苯妥英(20 mg/kg,至少20 min)治疗。研究的主要终点是分组到癫痫抽搐状态停止的时间。

286名患儿接受了治疗,152人被分配到左乙拉西坦组,134人被分配到苯妥英组。左乙拉西坦组106名(70%)儿童和苯妥英钠组86名(64%)儿童的惊厥状态终止。从随机分组到癫痫抽搐状态停止的中位时间,左乙拉西坦组为35分钟,苯妥英钠组为45分钟(HR=1.20)。

【3】10价肺炎球菌结合疫苗显著降低肯尼亚肺炎球菌感染风险


2011年1月肯尼亚开始接种10价肺炎球菌结合疫苗(PCV 10),该疫苗在6、10和14周龄时接种,同时在Kilifi地区为5岁以下的儿童开展了补种。2011年,Kilifi地区2-11个月的儿童中,至少两次PCV 10接种的覆盖率为80%,2016年为84%;12至59个月儿童中至少接种一次PCV 10的覆盖率2011年为66%,2016年为87%。本研究旨在评估PCV 10对Kilifi地区儿童和成人侵袭性肺炎球菌病(IPD)的影响。

3211403个随访年中,监测共发现667例IPD病例。注射疫苗后,5岁以下儿童的IPD发病率在2011年急剧下降,并保持在较低水平。(PCV 10型IPD:预防疫苗接种前为每10万随访年,60.8例,接种疫苗后为3.2例,[IRR =0.08]),由血清型引起的IPD分别为接种前,每10万随访年81.6例,接种后为15.3例 [IRR =0.32]。在未接种疫苗的年龄组中,(<2个月以下无未接种儿童) 5-14岁年龄段(IRR=0.26)和≥15岁年龄段(IRR=0.19)在PCV10型IPD也有所下降。非PCV 10型IPD的发生率在不同时代之间没有差异。

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    2019-09-15 howi
  2. [GetPortalCommentsPageByObjectIdResponse(id=1830089, encodeId=18f5183008958, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Sun Sep 15 01:37:00 CST 2019, time=2019-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=366818, encodeId=e2a936681854, content=向挑战病魔的科研人员致敬!, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e5171668917, createdName=坚强007, createdTime=Sun May 26 10:38:16 CST 2019, time=2019-05-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=366778, encodeId=2794366e7854, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=afa32365525, createdName=122e052cm96暂无昵称, createdTime=Sat May 25 21:57:23 CST 2019, time=2019-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=366776, encodeId=f1ef366e762d, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/2EVCwc9WmQS6ec99H2TX8ejmR40xYjwrIcrqjAnibV36aicL1sLxc21rhpZnqTOxk33HP44iayEwo6qYXqgZvdRtA/132, createdBy=d0d01573846, createdName=329523732, createdTime=Sat May 25 19:28:08 CST 2019, time=2019-05-25, status=1, ipAttribution=)]
    2019-05-26 坚强007

    向挑战病魔的科研人员致敬!

    0

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    2019-05-25 122e052cm96暂无昵称

    0

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    2019-05-25 329523732

    不错

    0

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